Intimate partner violence (IPV) remains a global human rights and public health challenge. Recent estimates suggest that 27% of ever-partnered women and girls aged 15-49 have experienced physical or sexual violence by an intimate partner, with the highest rates in low and middle-income countries (LMICs). IPV has major implications for the health and well-being of women, their families, and communities. Even prior to the onset of the COVID-19 pandemic, the world was not on track to meet Sustainable Development Goal 5.2, calling for the elimination of IPV, and evidence suggests the pandemic has only increased its prevalence.
How can intimate partner violence be prevented? One increasingly widespread strategy in LMICs centers around community mobilization or group-based trainings—targeting women, men, or couples—to change attitudes and behaviors linked to violence, usually implemented by non-governmental organizations. Prominent examples include SASA! (first implemented in Uganda), and Unite for a Better Life (first implemented in Ethiopia). The theory of change for these programs is straightforward: Shifting community attitudes and individual behaviors through peer-led and participatory processes will prevent violence.
As these programs have grown, they have also increasingly been rigorously evaluated in randomized controlled trials. To devise better programs and improve existing ones, policymakers need to better understand this growing body of evidence and its implications. Recently, I worked with an interdisciplinary team of researchers to aggregate in a systematic review all recent randomized trials analyzing community or group-based IPV prevention interventions in LMICs. We identified 30 research papers that met these criteria in very recent literature—two thirds published in the last five years. Most of this evidence is from sub-Saharan Africa (26 of 30 studies). Our goal was to provide a comprehensive answer to a simple question: Do these interventions work, on average, to prevent IPV?
The answer is yes. Our meta-analysis, published in the Journal of Global Health, suggests that on average, in families or communities exposed to these types of programs, the odds of a woman experiencing intimate partner violence decreases by more than 20%. (Since these estimates go beyond those who directly participated in a program, they encompass the average effect even for individuals uninterested in an intervention or otherwise hard to reach.) We included more than 100 different estimates of the effects of the interventions of interest on various measures of violence. While the follow-up periods vary, the majority of studies measure effects between six months and two years post-program. The overall effect captures only intimate partner violence (not other types of violence against women), but is observed consistently for different forms of IPV, including emotional, physical, and sexual IPV. This result is a huge success for anti-violence programming.
We also found that there is tremendous variation in the effect sizes across different programs implemented in different contexts. (In statistical terms, the I2 in the meta-analysis is more than 80%). We analyzed whether programs that are particularly effective have certain characteristics—for example, if programs targeting men, women, couples, or whole communities have better outcomes in reducing violence. We also explored whether programs that include additional material around certain themes (e.g., reproductive health, substance use, parenting, or economic welfare), and longer-lasting programs, are more effective.
The evidence suggests that all these features may play some role in the observed reduction in IPV. The most effective anti-violence programs targeted youth (individuals under 30). Including additional elements focusing on improving parenting skills or targeting challenges related to substance use also had a positive impact. Finally, the more effective interventions were simply longer, lasting more than nine months on average.
Conducting rigorous research around interventions targeting IPV offers an opportunity to identify the programs that work best to change peoples’ lives. This meta-analysis suggests that community mobilization and group-based interventions are indeed changing lives as they prevent violence on a large scale. The findings also provide some important pointers for designing future programs to maximize their effectiveness. Anti-violence programming has already had huge benefits for women and their families. Our analysis suggests ways to make simple changes to program design that could make those benefits even larger.
Jessica Leight is a Research Fellow with IFPRI’s Poverty, Gender, and Inclusion Unit.
